[Assembly of free osseous fragments in the treatment of injuries of the external orbital area].

The good long term results obtained following the remodeling of the frontal bandeau in craniosynostosis have demonstrated the viability of large bony segments following total periosteal stripping. In this present study, this concept has been applied in the management of acute midfacial fractures and their sequelae. To try to answer the fundamental questions of how wide of an exposure is needed for the treatment of these fractures, how denuded can bone segments be and expect to survive, and above all, how frequently is primary bone grafting needed, the author resorts to the complete detachment and removal of the fractured segments and their reassembly on a side table. This, theoretically, accomplishes the following: the best exposure of fragments, the best anatomical reduction, an accurate assessment of segmental loss and the need for immediate bone grafting, a normal topographical reconstruction. Bone scans have indicated long term perfusion in every case in which they were obtained. Except in cases of post traumatic deformity correction, bone grafts were not needed. The free segment reassembly fractured facial bones is but one additional technique gained from craniofacial surgery. Much, however, remains to be learned about large free segment revascularization and healing.